| NPI | 1821302548 |
|---|---|
| Doing Business As | OLD TOWN OPTICAL |
| Entity Type | Organization |
| Authorized Contact | NATHAN GALE BAAS Optometrist 231-946-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004139) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-08-05 |